Neurosurgical Trauma

Question 1

MC symptoms of raised ICP

Answer 1

headache and vomiting
papilledema - intracranial HPN present for days or weeks

INFANTS
irritability
bulging fontanelle
dilated scalp veins

Question 2

CUSHING TRIAD

Answer 2

HYPERTENSION
bradycardia
irregular respiration

Question 3

CINGULATE GYRUS in the medial frontal lobe herniates underneath the falx cerebri to the contralateral side

Answer 3

SUBFALCINE HERNIATION

LEG WEAKNESS

Question 4

UNCUS herniates into the TENTORIAL OPENING

Answer 4

TRANSTENTORIAL OR UNCAL HERNIATION

CN III palsy that is ipsilateral and weakness that is contralateral to the lesion

Kernohan phenomenon

Question 5

CEREBELLAR TONSILS herniate into the FORAMEN MAGNUM

Answer 5

TONSILLAR HERNIATION

neck pain
irregular respiration
may be precipitated by rapid CSF
CONING

Question 6

BRAINSTEM into the FORAMEN MAGNUM

Answer 6

CENTRAL HERNIATION

decreased sensorium, decorticate pr decerebrate posturing, irregular breathing, EOMs

Question 7

MOTOR WEAKNESS with IMPAIRED pain and temperature sense BELOW the lesion

Answer 7

ANTERIOR CORD SYNDROME

d.t. hyperFLEXION
POOREST prognosis

Question 8

Impaired PROPRIOCEPTION and VIBRATION sense below the lesion

Answer 8

POSTERIOR CORD SYNDROME

rare

Question 9

UPPER EXTREMITIES weaker than lower extremities

Variable sensory alteration – cape like pattern of numbness

Impaired BOWEL and BLADDER CONTROL

Answer 9

CENTRAL CORD SYNDROME

d.t. hyperEXTENSION in the setting of preexisting spinal canal stenosis

Question 10

IPSILATERAL motor weakness and impairment of PROPRIOCEPTION and VIBRATION sense BELOW the lesion

CONTRALATEAL impaired pain and temperature sense below the lesion

Answer 10

BROWN SEQUARD SYNDROME

seen in penetrating spine injuries or spinal epidural hematoma

BEST prognosis